• Pulse Points
  • Posts
  • ⚡️ State Medicaid portal access restored

⚡️ State Medicaid portal access restored

Cigna drug cost efforts, Easing nurse strain with AI, Addressing nursing shortages, and more!

Author

Pulse Points
January 30, 2025

In this edition:

  • ⚡️ State Medicaid portal access restored

  • 💊 Cigna takes steps to lower drug costs

  • 💻 Easing nurse workloads with AI

  • 🏛️ How CNOs are addressing workforce shortages

  • And more!

States regain access to Medicaid portals

After losing access to a Medicaid federal funding portal after an aid freeze by the Trump administration, states say they’re regaining access, but some are reporting that the site isn’t functioning “correctly.”

One day after the Office of Management and Budget (OMB) issued a memo stating agencies must halt “all activities related to obligation or disbursement of all federal financial assistance,” state Medicaid offices reported they had lost access to the payment portal through which federal funds are drawn.

Cigna takes steps to lower drug costs

Cigna plans to make changes to help lower out-of-pocket cost of prescription drugs, the company said on Wednesday, as it responds to criticism over the role of its pharmacy benefit manager in driving up drug costs.

The changes will allow patients access to lower prices negotiated by Cigna's pharmacy benefit manager, Express Scripts.

The U.S. pays more for prescription medicines than any other country, and the nation's three largest pharmacy benefit managers have allegedly significantly marked up the prices of certain medicines, a recent report by the U.S. Federal Trade Commission showed.

How gen AI can help doctors and nurses ease their administrative workloads

Did you know doctors and nurses spend more than a third of their work week on paperwork?

This includes maintaining detailed patient records, completing insurance forms and referrals, documenting procedures performed, organizing documentation for claims and inputting claim information into the system.

A study published today by Google Cloud and The Harris Poll sheds light on the extent of this burden — and it also highlights how generative AI (gen AI) can help.

Clinicians, including doctors and nurses in the United States, report that nearly 28 hours of each week are lost to administrative tasks, leaving less time for what truly matters: patient care.

It's no wonder that 82% of clinicians report feeling burned out. This isn't just a doctor problem: Insurance staff face an even bigger mountain of paperwork, spending 36 hours a week on administrative duties, such as maintaining member records and compiling documentation for claims.

Coders Beware: Newly Updated Overpayment Refund Rule

The Centers for Medicare & Medicaid Services (CMS) have issued the display copy of the Final Rule interpreting the 60-day Refund Rule for Medicare Parts A/B (Traditional Medicare) and C/D (Medicare Advantage, or MA, and the Prescription Drug Plans) established by the Patient Protection and Affordable Care Act.

Quest completes acquisition

Quest Diagnostics on Monday announced it completed its previously announced acquisition of select assets of University Hospitals, one of the nation’s leading nonprofit health systems and academic medical centers.

Financial terms were not disclosed.

How CNOs are Tackling Nurse Recruitment in 2025

Nurse recruitment remains a priority for CNOs and healthcare executives everywhere in 2025 as the workforce shortage continues.

In the United States, the Bureau of Labor Statistics expects the number of registered nurses to grow by 6% before 2033. According to the Health Resources and Service Administration workforce projections, between 2025 and 2037, show the demand for registered nurses is going to continue to outpace the supply.

The Winning Edge for Recruiting the Best Nurses webinar included three experts on the subject.

The key topics included:

  • Leveraging social media

  • Pairing retention and recruitment

  • Embracing new generational ideas